DYING TO LIVE

Past ignorance creates present 'silent epidemic'

Hepatitis C is the leading cause of liver transplantation and the nation's most common chronic infectious disease, far more prevalent than HIV.

An estimated 3 million people in the United States are infected with the virus, and most don't know it. That's why hepatitis C is known as the "silent epidemic."

By contrast, the Centers for Disease Control estimates that about 950,000 Americans are infected with HIV.

Usually it takes decades after infection for hepatitis C to cause noticeable symptoms, and then it just occurs in about a fifth of the people harboring the virus.

Dr. Joseph Bloomer, head of the UAB Liver Center, said most infected people die never knowing they had hepatitis C. "You die with it, not because of it," he said.

But problems with hepatitis C have been increasing for more than a decade, the product of ignorance about the disease in the 1960s,'70s and'80s. Most doctors weren't even aware that the virus existed before the 1990s. It spread rapidly through needle sharing by IV drug users, blood transfusions and blood products.

In 1992, a test was developed to detect hepatitis C, and the virus has been virtually eliminated from the blood supply. A treatment is available, too, if the virus is detected early enough.

Public health campaigns have been aimed at teaching people the risk of sharing needles. The virus can even be transmitted through straws people share to snort drugs. Hepatitis C can also be transmitted through needles used in body piercing and tattoos.

New infections have plummeted since testing of the blood supply started, but the nation is left with a critical mass of people who were infected before the danger was apparent. Cases of liver disease caused by the virus are expected to increase until 2015.

Bloomer said more than 40 percent of the patients treated for liver disease at the University of Alabama at Birmingham have hepatitis C. Many of these patients have been heavy drinkers, too. Alcohol compounds the problem and increases the rate of liver damage caused by hepatitis C.

Other causes of liver failure and transplant include cirrhosis caused by alcohol, other forms of hepatitis, obstruction of bile ducts, metabolic disorders, drug-induced injuries, tumors and problems with blood vessels.